Hepatitis A is a liver infection caused by the hepatitis A virus (HAV). It can range from a mild illness lasting a few weeks to a severe illness lasting several months. Although rare, HAV can cause death in some people. Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person.

What is post-exposure prophylaxis (PEP)?

Post-exposure prophylaxis (PEP) refers to trying to prevent or treat a disease after an exposure. Depending upon an individual’s age and health status, PEP for hepatitis A is an injection of either immune globulin (IG) or hepatitis A vaccine. However, the vaccine or IG are only effective in preventing hepatitis A if given within the first 2 weeks after exposure.

What is immune globulin (IG)?

Hepatitis A immune globulin (IG) contains antibodies that destroy the hepatitis A virus and provides short-term protection against hepatitis A infection for up to 2 months depending on the dosage given. It must be given within 2 weeks after exposure for the best protection. IG is generally administered via injection into a large muscle mass such as the upper leg or hip area.

What is the hepatitis A vaccine?

Hepatitis A vaccine is safe and effective vaccine used to prevent hepatitis A. It is given in 2 doses, 6 months apart. The hepatitis A vaccine does not cause hepatitis because it does not contain the live virus. It contains inactivated hepatitis A virus. The vaccine works by stimulating the body to produce antibodies, which are proteins that will fight and kill the virus and prevent hepatitis A infection. The Hepatitis A vaccine is administered via an injection in the arm.

How do I get my second dose of Hepatitis A vaccine?

Contact your personal health care provider to discuss this.

Is it worthwhile to administer the first dose of hepatitis A vaccine if the timing of the second dose cannot be assured?

Yes, It is not known for how long protection from one hepatitis A vaccine dose lasts, but it has been shown to last for at least 10 years (33). One dose of single-antigen hepatitis A vaccine administered at any time before International travel can provide adequate protection for most healthy persons.

Can a patient receive the first dose of hepatitis A vaccine from one manufacturer and the second (last) dose from another manufacturer?

Yes. Results of several studies indicate that the response of adults administered hepatitis A vaccine according to a schedule that mixed the two single-antigen vaccines currently licensed in the United States was equivalent to that of adults vaccinated according to the licensed schedules with the single vaccine.

What should be done if the second (last) dose of hepatitis A vaccine is delayed?

The second dose should be given as soon as possible. Even if the second does is delayed, the first dose does not need to be repeated.

Can hepatitis A vaccine be given during pregnancy?

The safety of hepatitis A vaccination during pregnancy has not been determined; however, because hepatitis A vaccine is produced from inactivated HAV, the theoretic risk to the developing fetus is expected to be low. The risk associated with vaccination should be weighed against the risk for hepatitis A in pregnant women who might be at high risk for exposure to hepatitis A virus.

Can hepatitis A vaccine be given to people with compromised immune systems, such as hemodialysis patients or people with AIDS?

Yes. The hepatitis A vaccine is inactivated (not “live”), so it can be given to people with compromised immune systems.

Is it harmful to have an extra dose of hepatitis A vaccine or to repeat the entire hepatitis A vaccine series?

No, getting extra doses of hepatitis A vaccine is not harmful.

Who should NOT receive the hepatitis A vaccine?

People who have ever had a serious allergic reaction to the hepatitis A vaccine or who are known to be allergic to any part of the hepatitis A vaccine should not receive the vaccine. Tell your doctor if you have any severe allergies. Also, the vaccine is not licensed for use in infants under age 1 year.

Will the hepatitis A vaccine protect me from other forms of hepatitis?

No, the hepatitis A vaccine will only protect you against hepatitis A. There is a separate vaccine available for hepatitis B. There is also a combination hepatitis A and hepatitis B vaccine that offers protection for both viruses. There is no vaccine for hepatitis C at this time.

What are the signs & symptoms of hepatitis A Infection?

Some persons, particularly young children, are asymptomatic (no symptoms). When symptoms are present, they usually occur abruptly (rapid onset) and may include the following:

Fever

Fatigue

Loss of appetite

Nausea

Vomiting

Abdominal pain

Dark urine

Clay-colored bowel movements

Joint pain

Jaundice

If I have symptoms of hepatitis A what should I do?

Call your personal health care provider.

What is the incubation period for hepatitis A (period of time between infection and the appearance of signs & symptoms)?

The average incubation period for hepatitis A is 28 days (range: 15–50 days).

How is Hepatitis A spread?

Person-to-person transmission through the fecal-oral route (i.e., ingestion of something that has been contaminated with the feces of an infected person) is the primary means of hepatitis A virus transmission in the United States.

Ingestion of uncooked HAV-contaminated foods or cooked food where the temperature during food preparation was inadequate to kill the virus or, the food was contaminated after cooking (food handled by infected food handler)

Eating raw shellfish from water polluted with sewage

Being in close contact with a person who's infected - even if that person has no signs or symptoms

Having sex with someone who has the virus

Exposure to food or water contaminated with feces (stool)

Waterborne outbreaks are unlikely as the chlorine added to water in the United States kills the hepatitis A virus

If I already had hepatitis A can I get it again?

No. Once you have had hepatitis A, you cannot get it again. Also, hepatitis A does not become chronic.

How long does hepatitis A virus survive outside the body?

The hepatitis A virus is able to survive outside the body for months.

How can the virus be killed?

The virus is killed by heating to 185 degrees F (85 degrees C) for one minute, however the virus can still be spread from cooked food if it is contaminated after cooking. Adequate chlorination of water, as recommended in the United States, kills hepatitis A virus that enters the water supply. Freezing temperatures do not kill the virus.

How is Hepatitis A prevented?

The best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine

Immune globulin offers short-term protection against hepatitis A if given before or within 2 weeks after coming in contact with HAV

Practicing good hand hygiene including thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food; see next question to find out the right way to wash your hands

What is the right way to wash your hands?

Follow the 5 steps below to wash your hands the right way every time.

Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.

Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.

Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.

Rinse your hands well under clean, running water.

Dry your hands using a clean towel or air dry them.

This video can also help you learn how to wash your hands the right way.

The Erie County Department of Health does not provide medical advice. The information provided on the Erie County Department of Health website is not an attempt to practice medicine and is not intended as a substitute for professional medical advice, diagnosis, or treatment. It is for informational purposes only. Always seek the advice of your personal physician or other qualified health provider with any questions you may have regarding a medical condition or issue. Never disregard professional medical advice or delay in seeking it because of the content found on the Erie County Department of Health website or this correspondence.